First Large-scale Study Finds Cognitive Training Aids in Long-term Function in Older People

By Tara Bahrampour, Washington Post, January 13, 2014

The first large-scale trial to show that training improves cognitive function in older adults could reduce the number of people experiencing functional impairment by 38 percent by 2050, according to a new report.

The Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study, scheduled to be released Monday, followed 2,832 people age 65 and older in six U.S. metropolitan areas for 10 years after they had received 10 hours of training in either memory, reasoning or speed-of-processing, or were part of a control group that received no training. Research had indicated that these areas show early age-related decline and are related to activities of daily living.

The average age of participants in the study, which was conducted by a group of scientists from across the nation, was nearly 74 when the study began; three-quarters of the participants were white and one-quarter were African American. All participants were relatively healthy and lived in their communities as opposed to nursing homes or other institutions. Training was conducted in small groups in 10 sessions of 60 to 75 minutes each over five to six weeks, and it included exercises such as memorizing lists, detecting patterns in number series and becoming faster at using a touch-screen program.

Participants who received the training reported better functioning in daily activities. Their cognitive ability improved in the areas they were trained in. However, the specialized training did not help them in the areas they had not been trained in. For example, those who had received speed-of-processing training were better at cognitive tests emphasizing speed, which could translate into things such as driving and multitasking; people who had received reasoning training were better at cognitive tests emphasizing reasoning, which could translate into filling out forms; and people who had had memory training were better at cognitive tests emphasizing memory, which could translate into remembering what to buy at the grocery store or when to take medications.

Five years after the training, participants in all three groups showed better skills in the areas they had been trained in. After 10 years, the reasoning and speed-of-processing groups still showed better skills, although the memory group did not.

“The effects on cognition — except for memory — were quite robust,” said Jonathan King, a project scientist at the National Institute on Aging’s Division of Behavioral and Social Research, who is one of the report’s authors. He added that the findings could encourage researchers to pursue more studies on how the processes work and to develop more specific types of cognitive training, including training tailored to an individual’s needs.

In recent years, as the baby-boom generation ages, online programs to help exercise the brain, such as Lumosity, have increased in popularity. But for the most part, these have not gone through rigorous clinical trials, King said.

“We neither endorse nor criticize these commercial products,” he said. “We don’t know their methodology, how long it lasts or whether it leads to the kind of improvement that people are hoping for.”

Although the ACTIVE study was not designed to address dementia, the cognitive training may help delay its onset, according to the report, which concluded that “if interventions that could delay onset of functional impairment by even 6 years were introduced, the number of people affected by 2050 would be reduced by 38%, which would be of great public health significance.”